Uruguay attacked throughout the second half, finishing with four forwards on the field, but were unable to find a way past Claudio Bravo.
The draw left with Chile with 20 points from 12 games, keeping them in the top four of the 10-team South American group and on course for their first World Cup finals appearance since 1998.
Twice world champions Uruguay have 17 points and are fifth.
The top four teams qualify for South Africa 2010 and the fifth will play off over two legs against the fourth side from the CONCACAF zone for another place.
Chile created the best first-half chance when Alexis Sanchez headed against the crossbar after a strong run by Humberto Suazo.
But the game turned after Chile midfielder Mauricio Isla was sent off after being given a second yellow card for a seemingly innocuous challenge in the 34th minute.
Seeing a chance to snatch a priceless away win, Uruguay came out and attacked in the second half.
Luis Suarez shot over after a counter-attack and Chile goalkeeper Claudio Bravo made a stunning close-range save to turn over Cristian Rodriguez volley as the visitors pressed forward.
Diego Forlan missed an excellent chance, shooting over when Martin Caceres found him with time and space in the penalty area and then saw another effort turned around the post by Bravo.
Uruguay's last chance came in injury-time when Sebastrian Abreu headed over from a corner.
